Hello XXXXXXX

Thanks for writing in.

This is Dr Vivek answering your question.
From information provided, you are a 55 years old gentleman opting for male breast reduction surgery.

As you have not mentioned any underlying condition, I assume you have idiopathic gynaecomastia.
This is a harmless benign condition. Routine blood examination like hemoglobin, blood clotting, prothrombin, partial thromboplastin time, blood sugar and screening infections are essential.

There are three procedures by which breast reduction surgery is done in males.
1.     Subcutaneous mastectomy or surgical resection: Here reduction is done using various skin incisions (usually the Webster intra areolar incision) in the central part of the breast.
2.     Two-stage breast reduction for moderate-to-severe gynecomastia: In one liposuction followed and Webster-type periareola incision with removal of gland, fat, and fibrous tissue is performed. The second stage takes place 4-6 months later and is a periareola donut mastopexy.
3.     Liposuction assisted mastectomy: This is helpful on in patients with fatty gynaecomastia, those in whom fat content in breast is more.

Post operatively, you may be required to wear a compression garment for upto 4 weeks by when there is complete healing. You may be discharged from hospital in 1-2 days if your surgery goes on well and can start with your daily activities as early as 2 days after surgery.

The size reduction part depends on your body structure, the amount of fat and glandular components in your breast. Please have a detailed discussion on this with the surgeon.

Surgery is a skill and your surgeon must explain all details to you before operating. All surgical procedures come with complications and I am sure your doctor will be ready to explain them to you. The success rate of breast reduction surgery is quite high.

Wishing you good health.

Further questions welcome.
If you don't have any more questions, I request you to please close this thread and post a feedback.

Regards,
Dr Vivek

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Hello,

Thanks for clearing up the air and hope I am able to answer your exact queries.

I would like to inform you that your query has been posted under Men’s Health and your gender mentioned in the patient profile is male and therefore the earlier discussion was on male breast reduction surgery and hence the confusion.


Coming to your queries:

As you might know degenerative disc disease can be a good justification for breast reduction surgery. In women with 38 triple D before surgery, following breast reduction, a size of C cup can be achieved in most of them. Keeping the back pain in mind, your height and present body weight are also of concern. It is important for you to know that cup size is not the only criterion in breast reduction surgery for females. Post reduction you should be aesthetically comfortable with your appearance. This includes breast size, shape, nipple contour, symmetry, thoracic diameter and of course the cup volume. So there are many factors under scrutiny in case of females undergoing breast reduction. After the surgery I am sure you would like your back pain to improve and that you have an aesthetic appearance as well. You could discuss this in detail with your doctor. Your abdominal girth and hip/ waist measurements also need to be correlated with your breast reduction.

Coming to the surgery, liposuction-only breast reduction is one of the current techniques for breast reduction and is well accepted by patients.
As mentioned earlier, routine blood examination like hemoglobin, blood clotting, prothrombin, partial thromboplastin time, blood sugar and screening infections are essential.

You need to have a mammography (x XXXXXXX mammography or ultrasound mammography) of both breasts. This is to assess the fatty component and glandular to fat tissue ratio. A chest x XXXXXXX may be done as pre operative routine.

The surgery may require an overnight observation at the hospital. You may be given general anaesthesia during the surgery. The surgeon will make one or two small holes in each breast. Fluid is infiltrated into the breasts. Then after a while, the fluid is taken out using suction. Throughout the procedure, the suction amount for each breast is recorded separately. Your surgeon will know when to stop the procedure. Then by another suction manoeuvre, the superficial fat layer is undermined. Towards the end of the surgery, an elastic foam tape is applied over the breast to mould the breast.

It may be required that you don’t involve yourself in activities like bending or lifting weights for at least two weeks. Early activity can give rise to complications such as bleeding at operative site and hematoma formation. Little post operative oozing is acceptable though in the first few days. While sleeping, please avoid turning over in your sleep. At the end of a week you could be on your own.

The period of recovery varies among individuals. It can take somewhere between 3 to 6 weeks for the XXXXXXX healing to take place. Most women get back to normal activity within a month or two. It depends what kind of job you are into. In a desk job, you may have little discomfort in moving your arms initially, this will gradually improve. Always ask your doctor before you starting any specific strenuous physical activity. In 6 months time you can expect a total recovery.

Surgery is a skill and you may request your surgeon concerning any preferences on the appearance of your breasts after breast reduction surgery. All surgical procedures come with complications and I am sure your doctor will be ready to explain them to you.

Wishing you good health.

Further questions welcome.
If you don't have any more questions, I request you to please close this thread and post a feedback.

Regards,
Dr Vivek

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